DESPITE SPENDING DRAMATICALLY MORE ON HEALTH care than other high-income nations, the United States has the worst health outcomes on nearly all metrics. That is the conclusion of a new report. Today we explore health outcomes in the USA compared to wealthy countries.
Americans live shorter and less healthy lives because our healthcare system is fundamentally flawed. We have issues of access to care, high costs, and inadequate investment in health equity and social services that are known to promote population health.
Now comes a study from the Commonwealth Fund that analyzes health outcomes in the USA, comparing them to other high-income nations (including Australia, Canada, Germany, Japan, South Korea, and the United Kingdom).
I want to present some observations from this critical study. I will end by offering some suggestions for you to optimize your health despite a remarkably flawed healthcare system.
“If we are creating ourselves all the time, then it is never too late to begin creating the bodies we want instead of the ones we mistakenly assume we are stuck with.”
― Deepak Chopra
Commonwealth Fund report
Before we get into health outcomes, let’s begin with this disturbing observation: The United States is the only nation evaluated that does not guarantee health coverage.
Nearly nine percent of Americans were uninsured in 2021. Moreover, United States residents had the fewest annual healthcare visits compared to the other countries.
We Americans are health-challenged: Thirty percent of adults have multiple chronic conditions, reporting two or more conditions such as heart disease, depression, anxiety, other mental health conditions, asthma or chronic lung disease, heart disease, and high blood pressure (hypertension).
The second worst country (regarding multiple chronic health conditions) was Australia, with 26 percent reporting two or more problems.
The USA is an outlier in terms of healthcare spending
The disturbing American numbers are despite outsized spending on healthcare. The Commonwealth Fund reminds us that we spend more on health care than other wealthy nations. Here is the percentage of the Gross Domestic Product (GDP) spent on health by country:
Looking at dollars spent per capita, the United States spends three to four times more on health than South Korea, Japan, and New Zealand.
Commonwealth Fund report on health outcomes
Among its 12 peer countries, the United States had the worst rates for the following measures:
- Life expectancy
- Death due to assault
- Avoidable deaths
- Infant and maternal mortality
- Obesity
One of the only measures that the United States did not have the worst outcome was suicide rates. The USA ranked third, with 14.1 suicides per 100,000 people. South Korea fared the worst, with 24.1 suicides per 100,000. Japan was the second worst, at 14.6 suicides per 100,000 individuals.
Here are the numbers for death secondary to assault:
The obesity numbers are concerning, too. The rate is nearly double the average of the OECD (the Organization for Economic Co-operation and Development).
The United States spends the most on healthcare but has some of the worst outcomes among high-income countries. One area we appear to shine is cancer prevention and treating cancers early. With Sweden, the USA had the highest number of breast cancer screenings among women ages 50 to 69, and the USA exceeded the OECD average for colorectal screening.
A separate research paper published earlier this year noted that the US cancer rate has dropped by one-third since 1991, corresponding to approximately 3.8 million deaths averted.
Commonwealth Fund health report — My take
The Commonwealth Fund health report confirms that the United States continues to spend more than any other country and yet has the worst health outcomes (among high-income countries).
We are not getting the best value for our dollar. Universal health care among other leading countries is likely a significant contributor to this problem.
Second, we need to do better in primary care prevention. Our fractured health system makes this more challenging. Third, we need to invest better in upfront support for our people while reducing healthcare disparities. While we spend much on sick care, we must improve upfront prevention and risk reduction.
The study serves as a reminder that we can help ourselves by:
- Seeing a primary care provider.
- Not smoking.
- Being prudent about alcohol consumption.
- Remembering to build a community around ourselves.
- Eating well and watching our weight.
- Getting regular physical activity.
- Aiming for seven to nine hours of quality sleep daily.
- Reducing stress.
Small personal changes can result in huge health gains. We need to take better care of ourselves. For some things, the health system can be remarkably effective (I would prefer to be in the USA if I have cancer, for example).
I will not place all of the blame on the healthcare system here, flawed as it is. Still, the study authors get this right: We need better comprehensive, continuous, well-coordinated, and well-compensated primary care.
Critical to this is developing the capacity to offer comprehensive, continuous, well-coordinated care.
The information I provided in this blog is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you seek medical advice, diagnoses, or treatment. I am not liable for risks or issues associated with using or acting upon the information in this blog.
Thanks for reading “Is the USA last in health outcomes?”
